April 17, 2018 : DCMS #393

DISASTERS AVERTED — Near Miss Case Studies

Know the Difference When Choosing Between CGMs

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Swapnil N. Rajpathak Part 5, Future Real World Study Research For Merck

HOMERUN SLIDES — Great Clinical Presentation Highlights

Hypertension Update 2018 Part 6

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #121: The Insulin Resistance Syndrome Part 2

MOST POPULAR ARTICLES OF THE MONTH

#1 New Way to Screen for Diabetes and Prediabetes
#2 We Repeat: Teach To Remove The Needle Shield!
#3 Analysis: How Patients and HCPs Really Feel About CGMS

The guideline for all diabetes patients is to get them on an ACE or an ARB when diagnosed, regardless of BP levels. This is so important that Medicare and Medicaid rate prescribers based on their patients’ adherence to these medications. The logic behind that rule has to do with the well-documented increased risk of kidney failure in diabetes patients.

This week in our Homerun Slides, we look at Albuminuria and how this indicator of kidney failure is defined and documented. We also look at the correlation of high albuminuria and cardiovascular mortality and how newer medications for diabetes lower your patients’ risk for albuminuria and cardiovascular complications.

Dave Joffe

Editor-in-chief

You may wonder which CGM monitor is best for your patients. I know I do.

Learn from Dr. Stephen W. Ponder, MD, FAAP, CDE-AADE Educator of the Year, Board Certified Pediatric Endocrinologist, Pediatric Residency Program Director at Baylor Scott & White McLane Children’s Hospital and 50 year Joslin Medalist. He also helps people with diabetes through the “sugar surfing” method to empower individuals who have diabetes to live fuller and more satisfying lives.

In part 5, the conclusion of this Exclusive Interview, Dr. Swapnil N. Rajpathak talks with Diabetes in Control Publisher Steve Freed during the ADA 2017 Scientific Sessions in San Diego, CA about upcoming research studies on patient adherence.

In this week’s Homerun Slides, defining albuminuria, a marker for kidney dysfunction.

Concept of ectopic fat as a cause of tissue insulin resistance: It appears that individuals prone to T2DM (based in part on their nonmodifiable characteristics) show a greater propensity to accumulate visceral or ectopic fat for a given weight. Interestingly this characteristic, in turn, may be a downstream consequence of “impaired” subcutaneous fat storage capacity, the mechanisms of which deserve further research. As an extreme example of this concept, lipodystrophic individuals have an impaired ability to store subcutaneous fat and, as a consequence, they accumulate fat in visceral and ectopic tissues and so have marked insulin resistance.

Dental exams may be earlier predictor of disease than even blood tests.

Last week I was teaching a patient how to self inject an injectable medication. As I was going through the steps, I told her twice of the importance of removing not only the outer cover of the needle, but also the needle shield. She gave me one of those looks like, “Why did you tell me this twice?” Then she said, “I know!”

Both patients with diabetes and health care professionals expect wider adoption of continuous glucose management systems in the future for patients with type 2 as well as type 1, and agree that cost is a key factor in patient choices